@article{oai:twinkle.repo.nii.ac.jp:00019829,
 author = {KATSURAGAWA, Hideo and YAMAMOTO, Masakazu and KATAGIRI, Satoshi and TAKASAKI, Ken},
 issue = {4},
 journal = {東京女子医科大学雑誌},
 month = {Apr},
 note = {[目的]肝細胞癌破裂は,腹腔内出血という緊急の病態を引き起こし,また癌細胞の播種の危険に曝され予後不良とされている.しかし実際の破裂切除例での術後経過が観察された報告は少ない.そこで破裂切除例の臨床病理像,術後経過を検討した.[方法]対象は1987～1995年の期間に切除された肝細胞癌612例中の破裂例23例である.その臨床像,病理像を検討した.手術所見での腹腔内出血の型から,I型:腹腔内に開放性に出血した型,II型:出血が周囲臓器および被膜に被包され限局した型,に分類した.[結果]破裂肝癌例は肉眼的血管侵襲,肝内転移が有意に多く,生存率は非破裂肝癌例が破裂例に比し良く,術後腹膜播種は破裂例に有意に多かった.破裂例の腹腔内出血の型別では,I型の生存期間が短かった.[結語]破裂肝癌切除例では,進展因子,術後腹膜播種は有意に多く予後は不良であった.破裂する肝癌例は生物学的に悪性度が高いことが想定され,それを念頭においた治療が必要である., Ruptured hepatocellular carcinoma (HCC) causes acute hemorrhage, and requires emergency procedures. The condition is therefore involves the risk of peritoneal dissemination and is associated with poor prognosis. There have been few reports concerning the outcome after ruptured HCC resection. Methods : We compared the outcomes in 23 patients with ruptured HCC clinicopathologically with those in 589 patients with non-ruptured HCC. Ruptured HCC cases were divided into two types according to the extent of bleeding, Type I : extended intraperitoneal bleeding, Type II : bleeding blocked by the surrounding organs. Results : Vascular invasion, and intrahepatic metastasis rate were significantly greater in the ruptured HCC group. The outcome of resection was poor in the Type I group, as opposed to in the Type II group. The cumulative survival rates were significantly better in the non-ruptured HCC group than in the ruptured HCC group. The rate of peritoneal dissemination after surgery was significantly higher in the ruptured HCC group than in the non-ruptured HCC group. Conclusion : The rate of vascular invasion, intrahepatic metastasis and peritoneal dissemination after surgery were significantly higher in the ruptured HCC group. We believe that the ruptured HCC group had high grade malignancy. And we have to treat ruptured HCC thinking that.},
 pages = {168--172},
 title = {Surgical Outcomes in Patients with Ruptured Hepatocellular Carcinoma},
 volume = {76},
 year = {2006}
}